Normative data for evaluating mild traumatic brain injury with a handheld neurocognitive assessment tool (original) (raw)
Related papers
Journal of the International Neuropsychological Society : JINS, 2017
The aim of this study was to evaluate the reliability and validity of three computerized neurocognitive assessment tools (CNTs; i.e., ANAM, DANA, and ImPACT) for assessing mild traumatic brain injury (mTBI) in patients recruited through a level I trauma center emergency department (ED). mTBI (n=94) and matched trauma control (n=80) subjects recruited from a level I trauma center emergency department completed symptom and neurocognitive assessments within 72 hr of injury and at 15 and 45 days post-injury. Concussion symptoms were also assessed via phone at 8 days post-injury. CNTs did not differentiate between groups at any time point (e.g., M 72-hr Cohen's d=-.16, .02, and .00 for ANAM, DANA, and ImPACT, respectively; negative values reflect greater impairment in the mTBI group). Roughly a quarter of stability coefficients were over .70 across measures and test-retest intervals in controls. In contrast, concussion symptom score differentiated mTBI vs. control groups acutely), wi...
International journal of sports physical therapy, 2017
One common component of concussion rehabilitation is a computerized cognitive test free of concomitant physical demands. Healthcare professionals may be able to provide more patient-centered care after a diagnosed concussion if specific areas of impairment are identified and treated, such as the physical aspect of neurocognitive function. Hypothesis/Purpose: To evaluate the test-retest reliability of a unique combination of neurocognitive assessment tools currently utilized in concussion assessments into one single, inclusive instrument that measures both neurocognitive function and physical capability. Original research - diagnostic tests. Fourteen individuals (nine males, age: 29 + 17.9, five females, age: 46.0 ± 21.5 years) either with normal cognitive function (NBI) without history of a health event (e.g. cerebral vascular accident/stroke, mTBI) that resulted in brain injury within one year of the study, or who had suffered a health event that has resulted in a medically documen...
Archives of Clinical Neuropsychology, 1997
Clinical neuropsychology has entered an era of accountability focused on the satisfaction of customer requirements. Our customers now include the patient, the family, the health care team, third party payors, social support agencies, and others invested in understanding the meaning and impact of brain illness or injury. Customer requirements are those criteria by which the customer judges the quality of the services performed (Baxter Healthcare Corporation, 1994). The historical approach to such requirements directs focus to the clinical utility of test measures: The measures' ability to reliably and validly reflect clinically meaningful behaviors for the populations and referral issues in question.
Validation of a Brief Cognitive Assessment for Concussion Delivered on a Mobile Device
Journal of pediatric neuropsychology, 2024
Previous research found the Conners Continuous Performance Test (3rd ed; CCPT3) to predict concussion outcomes, but delivery was on a desktop device which can undermine broad use. We examine whether a shortened, mobile CCPT3 predicts concussion symptom endorsement and severity, and evaluate whether the predictive validity changes after controlling for ADHD. From July 2021 to January 2022, 143 participants aged 11 to 23 (approximately 30% female), including 63 consecutively assessed individuals suspected of having a concussion, and 80 randomly selected healthy controls, completed the mobile CCPT3 and the 31-item CDC concussion symptom checklist with severity ratings. Regression analyses indicate the mobile CCPT3 accounts for 19% variance (p < 0.01, d = 0.97) in symptom severity and 17.2% variance (p < 0.01, d = 0.91) in symptom endorsement. Findings persist after controlling for the experience of ADHD. Moreover, CCPT3 scores can differentiate among those suspected of having a concussion, predicting 27.6% variance in total symptom severity (p = 0.02, d = 1.24). Thus, a brief, objective mobile cognitive assessment yields large effect sizes when predicting concussion symptoms, and findings are comparable to previous research. Because the mobile assessment can be administered almost immediately post-injury and in between clinical visits, it can further inform post-injury medical care, rehabilitation, and return-to-play decisions.
Factor Analysis of Computerized and Traditional Tests Used in Mild Brain Injury Research
Clinical Neuropsychologist, 2000
The present study examines the relation between a set of computerized neuropsychological measures, Automated Neuropsychological Assessment Metrics (ANAM), and a set of traditional clinical neuropsychological tests. Both sets of tests have been employed in recent studies of mild brain injury. Factor analysis and stepwise regression indicate that both sets of tests measure similar underlying constructs of cognitive processing speed, resistance to interference, and working memory. The present findings indicate strong concordance between computerized and traditional neuropsychological measures and support the construct validity of ANAM and similar procedures.
Journal of neurotrauma, 2018
Traumatic brain injury (TBI) often results in cognitive impairment, and trajectories of cognitive functioning can vary tremendously over time across survivors. Traditional approaches to measuring cognitive performance require face-to-face administration of a battery of objective neuropsychological tests, which can be time- and labor-intensive. There are numerous clinical and research contexts in which in-person testing is undesirable or unfeasible, including clinical monitoring of older adults or individuals with disability for whom travel is challenging, and epidemiological studies of geographically dispersed participants. A telephone-based method for measuring cognition could conserve resources and improve efficiency. The objective of this study is to examine the feasibility and usefulness of the Brief Test of Adult Cognition by Telephone (BTACT) among individuals who are 1 and 2 years post-moderate-to-severe TBI. A total of 463 individuals participated in the study at Year 1 post...
Journal of Neurotrauma, 2021
This study investigates subacute cognitive effects of mild traumatic brain injury (MTBI) in the Trondheim Mild TBI Study, as measured, in part, by the neuropsychological test battery of the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) program, including computerized tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and traditional paper-and-pencil tests. We investigated whether cognitive function was associated with injury severity: intracranial traumatic lesions on neuroimaging, witnessed loss of consciousness (LOC), or post-traumatic amnesia (PTA) >1 h. Further, we explored which of the tests in the CENTER-TBI battery might be associated with the largest subacute effects of MTBI (i.e., at 2 weeks postinjury). We recruited 177 patients with MTBI (16-59 years of age) from a regional trauma center and an outpatient clinic,79 trauma control participants, and 81 community control participants. The MTBI group differed from community controls only on one traditional test of processing speed (coding; p = 0.009, Cliff's delta [D] = 0.20). Patients with intracranial abnormalities performed worse than those without on a traditional test (phonemic verbal fluency; p = 0.043, D = 0.27), and patients with LOC performed differently on the Attention Switching Task from the CANTAB (p = 0.020, D =-0.20). Patients with PTA >1 h performed worse than those with <1 h on 10 measures, from traditional tests and the CANTAB (D = 0.33-0.20), likely attributable, at least in part, to pre-existing differences in intellectual functioning between groups. In general, those with MTBI had good neuropsychological outcome 2 weeks after injury and no particular CENTER-TBI computerized or traditional tests seemed to be more sensitive to subtle cognitive deficits.
Military Medicine, 2020
Introduction Military personnel and civilian athletes are both at risk for mild traumatic brain injury. However, these groups are unique in their training and typical daily activities. A fundamental gap in the evaluation of military personnel following mild traumatic brain injury is the lack of military-specific normative reference data. This project aimed to determine if a separate normative sample should be used for military personnel on their performance of the Cleveland Clinic Concussion application and a recently developed dual-task module. Methods Data were collected from healthy military personnel (n = 305) and civilians (n = 281) 18 to 30 years of age. Participants completed the following assessments: simple and choice reaction time, Trail Making tests A&B, processing speed test, single-task postural stability, single-task cognitive assessment, and dual-task assessment. Results Civilian participants outperformed military service members on all cognitive tasks under single- a...
Neuropsychological Assessment of Individuals with Mild Traumatic Brain Injury
The Clinical Neuropsychologist (Neuropsychology, Development and Cognition: Section D), 1998
Approaches to classifying neuropsychological impairment after brain tumor vary according to testing level (individual tests, domains, or global index) and source of reference (i.e., norms, controls, and pre-morbid functioning). This study aimed to compare rates of impairment according to different classification approaches. Participants were 44 individuals (57% female) with a primary brain tumor diagnosis (mean age = 45.6 years) and 44 matched control participants (59% female, mean age = 44.5 years). All participants completed a test battery that assesses pre-morbid IQ (Wechsler adult reading test), attention/processing speed (digit span, trail making test A), memory (Hopkins verbal learning test-revised, Rey-Osterrieth complex figure-recall), and executive function (trail making test B, Rey-Osterrieth complex figure copy, controlled oral word association test). Results indicated that across the different sources of reference, 86-93% of participants were classified as impaired at a test-specific level, 61-73% were classified as impaired at a domain-specific level, and 32-50% were classified as impaired at a global level. Rates of impairment did not significantly differ according to source of reference (p > 0.05); however, at the individual participant level, classification based on estimated pre-morbid IQ was often inconsistent with classification based on the norms or controls. Participants with brain tumor performed significantly poorer than matched controls on tests of neuropsychological functioning, including executive function (p = 0.001) and memory (p < 0.001), but not attention/processing speed (p > 0.05). These results highlight the need to examine individuals' performance across a multi-faceted neuropsychological test battery to avoid over-or underestimation of impairment.
PubMed, 2014
Objectives: Cognitive impairment is a common permanent sequela of traumatic brain injury (TBI). Its objectivization is based on neuropsychological and neurophysiological assessment. Neuropsychological evaluation requires a test battery, whereas for neurophysiological assessment the most significant is application of P300 Event-Related Potentials (ERPs). The aim of the study was to determine whether it is possible to differentiate between degrees of severity of TBI on the basis of neuropsychological and neurophysiological parameters. Patients and methods: A total of 90 patients with closed TBI were evaluated at least one year after trauma. Subjects were classified into three groups according to severity of TBI: mild, moderate and severe. In all subjects the Intelligence Test, the Wisconsin Card Sorting Test (WCST) and P300 ERPs were performed. Results: General intelligence measures did not prove sensitivity enough to differentiate levels of severity of TBI, whereas the number of achieved categories on the WCST significantly discerned patients with mild and moderate TBI from patients with severe TBI. Perseverative errors significantly separated patients with mild TBI from patients with moderate and severe TBI. Non-perseverative errors significantly differentiated only patients with mild TBI from patients with severe TBI. Finally, P300 latency (EPLAT) significantly differentiated patients with mild TBI from patients with moderate and severe TBI. The results show that the applied test battery can discriminate between different levels of severity of TBI and emphasize the importance of P300 ERP in the evaluation of patients with brain injury. Conclusions: Our findings indicate that the WCST and ERP P300 latency have a significant role in the assessment of cognitive deficit related to TBI.